AB0787 INTRAVENOUS IMMUNOGLOBULIN IN ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS. BIRMINGHAM VASCULITIS ACTIVITY SCORE OUTCOME IN THE DIFFERENT SUBTYPES
Authors: F. Benavides-Villanueva, C. Corrales-Selaya, J. Loricera, V. Calvo-Río, S. Castañeda, J. M. Blanco Madrigal, N. Aviles Mendez, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) includes granulomatosis with polyangiitis (GPA), Eosinophilic granulomatosis with polyangiitis (EGPA) and microscopic polyarteritis (MPA). AAV may be refractory to standard immunosuppressive treatment, that also may be accompanied by significant adverse events. Intravenous immunoglobulins (IVIG) may constitute a therapeutic alternative in these cases. <h3>Objectives</h3> To compare the effectiveness and safety of IVIG in the Birmingham Vasculitis Activity Score (BVAS) outcome on each type of clinical phenotype (GPA, EGPA and MPA). <h3>Methods</h3> Observational study of patients with AAV from a referral center treated with IVIG from January 2000 to December 2021. AAV diagnosis was based on a compatible clinical presentation, positive ANCA serology and/or histology. Disease activity was assessed with the Birmingham Vasculitis Activity Score (BVAS). All of them were measured at 1 month, 6 months, 1 and 2 years after IVIG onset. IVIG schedule was 2g/kg administered in 1-5 days. <h3>Results</h3> We included a total of 28 patients (13 females/15 males) with a mean±SD age of 57.1±18 years. The most frequent type of AAV was GPA (n=15, 53.6%), followed by MPA (n=10; 35.7%) and EGPA (n=3, 10.7%). The main features are summarized in <b>Table</b>. The reasons for using IVIG were: <b>a</b>) relapse or refractory disease (n=25); <b>b</b>) the presence (or suspicion) of infection (n=3); and <b>c</b>) both causes (n=5). The doses of IVIG were: 0.4 g/kg/day (5 days) (n=16), 0.5 g/kg/day (4 days) (n=8), and 1 g/kg/day (2 days) (n=4). There was an important, rapid and similar improvement on the BVAS score rate on each clinical phenotype <b>(Figure).</b> Three (10.7%) patients developed mild adverse events: headache (n=2), hypertension (n=1), and cutaneous rash (n=2). One patient developed congestive cardiac failure and had to stop the IVIG therapy. <h3>Conclusion</h3> IVIG are equally effective in AAV regardless of the vasculitis subtype. <h3>References</h3> [1]Jennette JC, et al. Arthritis Rheum 2013; 65: 1-11. PMID: 23045170 [2]Chung SA, et al. Arthritis Rheumatol 2021; 73: 1366-83. PMID: 34235894 [3]Crickxx E, et al. Arthritis Rheumatol 2016; 68:702–12. PMID: 26473632 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Fabricio Benavides-Villanueva: None declared, Cristina Corrales-Selaya: None declared, J. Loricera Speakers bureau: Dr. J. Loricera had participation in company-sponsored speaker´s bureau from Roche, Novartis, Galápagos, UCB Pharma, MSD, Celgene, and Grünenthal and received support for attending meetings and/or travel from Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos, Consultant of: Dr. J. Loricera had consultation fees in company-sponsored from Roche, Novartis, Galápagos, UCB Pharma, MSD, Celgene, and Grünenthal, Vanesa Calvo-Río: None declared, Santos Castañeda Grant/research support from: had grants/research support from MSD and Pfizer, and has received consultation fees in company-sponsored speaker's bureau from Amgen, BMS, Lilly, MSD, Novartis, Pfizer, Sanofi, Roche, Juan Maria Blanco Madrigal: None declared, NURIA AVILES MENDEZ: None declared, Ricardo Blanco Speakers bureau: Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, lilly, Bristol-Myers, Janssen, Galapagos and MSD, Consultant of: Ricardo Blanco Consultant of: Abbvie, Pfizer, Roche, lilly, Bristol-Myers, Janssen and MSD, Grant/research support from: Ricardo Blanco Grant/research support from: Abbvie, MSD, novartis and Roche.